Study Design. This study will include 95 Practices, 171 schools, and over 30,700 asthmatic patients. Five groups (A-E) will be evaluated to determine the effectiveness of each intervention. Group A is the usual care control group. Group B practices will provide a second control group with an EMR with decision support, Asthma action plans, and Population reports (EAP) at baseline. A time delay design will be used as all practices in Group B will receive the Integrated Approach to Care (IAC) intervention with 10-12 practices receiving the intervention every 2 months over a 1 year period of time. Four practices within Group C will receive the Shared Decision Making (SDM) approach intervention with 1 practice receiving the intervention every 4 months over a 2 year period. Group E will receive School Based Care (SBC) through case management within the schools.